Have You Been the Subject of Healthcare Fraud?

RyanD
May 17, 2013

Have you been the subject of healthcare fraud? According to the FBI website, healthcare fraud costs the US about $80 billion dollars per year. And some corrupt doctors are willing participate in healthcare fraud schemes for a price. The more expensive healthcare costs become, the higher a price we pay for the service. So eliminating healthcare fraud is an important way to keep healthcare costs down.

The Federal Bureau of Investigation is the primary law enforcement agency that works to prevent healthcare fraud, because they have jurisdiction over federally funded health care as well as private healthcare providers. In some way scam perpetrators get healthcare information from patients and use this information to take money that isn’t rightfully theirs. Some examples of potential healthcare fraud schemes are described in the following examples.

Some companies offer free or discounted medical supplies or equipment in exchange for insurance information. Once the people perpetrating the fraud have received your insurance information, your insurance company may be billed for medical supplies you don’t receive or for products you did not request and do not need.

Another type of healthcare fraud is the “Rolling lab” scheme. In this type of healthcare fraud, unnecessary or fake tests are given to people in health clubs, nursing homes or shopping centers. These unneeded tests are then billed to Medicare or to insurance providers.

Some frauds included billing health insurance or medicare for services not provided at all to the patient. Once a person or group of people have your healthcare information such as your insurance provider or Medicare information, they can charge your insurance or Medicare account for services not rendered at all.

Medicare fraud is a large problem in healthcare fraud today. Medicare fraud can be done in any of the forms mentioned above. Senior citizens are especially targeted for these types of fraud. To avoid this type of healthcare fraud, never give your Medicare information out to companies offering free supplies or discounted medical supplies or services over the phone. Once these companies have a patient’s Medicare information, they can charge unneeded and unwanted supplies and services to a Medicare account. Many items Medicare provides payment for need a doctor’s approval and signature before Medicare will pay for the supplies or services. Those perpetrating the scam have this covered by providing payment to unscrupulous doctors for their fraudulent signatures. They can also provide bogus signatures as well. Once the orders are signed by a doctor, whether the doctor is real or fake, the company can charge Medicare for services or supplies whether they are being provided or not.

There are methods of protecting patients and insurance companies from fraudulent Medicare and insurance costs. Never sign a blank insurance claim form. Never give a healthcare provider blanket permission for treatment. Contact your medical insurance provider to find out what you will be expected to pay out of pocket for services provided. Look over your insurance claims carefully and ask your insurance company about any questionable charges you may find. Only give your Medicare or insurance information out to healthcare providers who have provided an actual service for you. Keep track of your doctor’s appointments and any services or equipment they have ordered for you.

A patient who has experienced healthcare fraud does have the right to redeem their insurance claims due to fraud. For more information, contact the FBI Health Care Fraud website page.

Byline: Frank Burke writes on everything medical-related, from Medical Equipment Fraud to choosing the right health insurance plan.